The recent findings from the Human Genome Project advances in molecular biology will have a far-reaching impact on genetic screening, risk reduction and therapeutics. Practicing oncology nurses are seeking education to face a genetics era in cancer care. Over the past seven years, Fox Chase Cancer Center has provided basic cancer genetics courses to over 350 nurses. During the past three years an "Advanced Nurses' Training Course in Cancer Risk Counseling" has been conducted with 31 nurses to enhance skills in cancer genetic risk counseling. Course evaluations have revealed the need for more scientific background in cancer genetics and help in integrating cancer risk counseling skills into community-based practice. We therefore propose the following specific aims to increase the number of nurses skilled to provide cancer risk assessment and counseling: 1) to continue the current skills-building component of the advanced training focusing on comprehensive cancer risk assessment, communication of risk, and counseling related to the receipt of genetic test results; 2) to provide a scientific symposium covering genetic advances with an emphasis on genetic principles and techniques to strengthen nurses' foundation in genetics, and 3) to develop, implement and evaluate a mentoring program following the course that will provide reinforcement for counseling skills and guidance for critical evaluation of new developments as they appear in the clinical cancer genetics arena. These three aims will permit the provision of a full compliment of learning processes described in social learning theory, the framework on which the advanced course has been based, to provide knowledge to perform a skill, to observe and practice the skill in a supervised setting and to have reinforcement of the skill in the actual work environment. Course and mentoring evaluations will assess if this continuing education format is an effective method for preparing nurses skilled in the delivery of cancer genetic risk assessment and management.